What is healthy eating?

Liz Stathakis:

A healthy diet is one that fits within your budget, within your geography within your belief system.

Janet Lowndes:

Is it about this kind of diet culture that I’ve really taken on? Or is it that my body is physically saying that doesn’t feel so good.

Sam van Zweden:

I was spending all of my time thinking about my body and what was going into it and how that would affect its shape, that I realized this is not a way to live.

Sophie Smith:

My concept of healthy eating was you need to cut all the stuff out. So that did leave me to yeah, having a pretty long list of foods that I couldn’t eat or if I did eat, I feel really guilty about it.

Sam Ikin:

Hey, I’m Sam Ikin and this is Butterfly: Let’s talk. I think it’s about time we did a deep dive into what healthy eating really is and we’re not going to go into specific eating plans or programs, you need to talk to a dietician about that. We live in this world where big corporations are constantly marketing cheap addictive “food” (I just used air quotes) with very little nutritional value and we’ve all heard about the public health impacts of that.

It’s led to a growing distrust in the food system and increased fear of food in general. So, seeing an opportunity, in steps, the dieting industry—until recently, it was pretty much just the weight loss industry—has now rebranded itself to be more about health and wellness. So when we talk about healthy eating were coming from the point of view of people who have experienced an eating disorder or who are vulnerable to eating disorders, which as we’ve discussed in a lot of previous episodes is quite a lot of people.

So, lots of the diets which are constantly being spat out by the dieting industry or whatever it calls itself and not founded on sound nutritional science and in fact they put a lot of emphasis on restriction of food.

Liz:

I think that a big red flag is at the moment, this new wellbeing thing, it’s for wellbeing. But if anything tells you to buy a product or to buy this filler, this diet product, if it’s telling you to restrict any food, unless you’re an anaphylactic allergic to it, there really shouldn’t be anything that you’re saying, “I can never eat that”, because that starts creating this bunch of baskets of good and bad food. And then that creates that negative relationship with food. What you want is to be able to allow and have all foods.

Sam:

That’s Dietitian Liz Stathakis, and we’ll be hearing a lot more from her really soon, but she’s not the only one who’s said to avoid an eating plan that involves labeling foods as good or bad. In fact, all of the guests we spoke to in this episode said that restricting or completely cutting out any particular types of food should not be part of a healthy eating plan unless of course there’s a medical reason to do so.

Sophie:

Ideas around healthy eating or so based on restriction and deprivation, which I think is really messed up.

Janet:

Restriction often causes this sort of feast and famine mentality, physically and mentally where then we crave. The very thing that we’ve been restricting.

Sam van Zweden:

We know that a natural reaction to restriction is to go hard in the other direction. Um so that for me turned into a binge eating disorder.

Alex Rodriguez:

The more you ban yourself from something, the more you’re going to want it, the more your body’s going to want it, the more your mind is going to want it.

Sam:

I want to make the point now that when we talk about healthy eating we’re not talking about dieting.

Liz:

Dieting is usually to strip something out for the end goal of weight loss, or the new horrific term called wellness.

Sam:

I kind of introduced her before but just to make it official, this is Liz Stathakis.

Liz:

I’m a dietitian and a nutritionist. I’m an accredited practicing dietitian, which just means that I get regulated, basically, and I do ongoing training to make sure I’m up with everything. If you look up in any sort of dictionary, the definition of diet the example they give you, it’s like “Brenda started dieting again”, and I love it that they say “again” because you do have to keep doing it again and again because you can’t sustain it. It’s unsustainable.

Sam:

I don’t want to get too bogged down in commercial diets, but we need to make the point that a person’s diet, the act of dieting, and healthy eating are not the same thing. Many diets that are marketed as healthy are not founded on sound nutritional science.

Liz:

Restricting, cutting out is risking deficiency in a something. So if you cut out dairy going to risk of deficiency in calcium or protein…

Sam:

The official information on what’s good for us and what’s bad for us changes every few years. So there was a period where eggs were terrible and now eggs are amazingly good and we should eat many eggs. And there was a period where saturated fats would kill everybody and you get a heart attack from that. Now saturated fats are the new buzz thing and we are contributing more saturated fats. So it’s such a very fluid concept. It’s very difficult to keep up with. It must drive you nuts.

Liz:

It does drive me nuts. Yes. Anything like paleo keto all those sorts of things drives an eating disorder dietitian to despair. And there’s always going to be something else that promises wellness or that promises a quick fix. And um I think sometimes we get bored or we want a sense of achievement and so we latch onto these things and we try and change ourselves externally. But really we should probably be working on our internal selves.

Sam:

The National Eating Disorders Collaboration or the N. E. D. C. Reports that 35% of normal dieters progressed to pathological dieting, and 20-25% of those individuals develop eating disorders. And that’s something that our next guest can relate to.

Alex:

Name’s Alex. I’m 23 from Melbourne. I’m studying dietetics at Monash University. I just finished my exam today funnily enough and I’m looking forward to working as a dietician alongside beautiful other health professionals in the eating disorder space for the rest of my life.

Sam:

Like so many of us Alex’s disordered eating started when he was very young.

Alex:

I’ve always been a very anxious person, quite an obsessive person. Even back in early primary school and I guess after my mom and dad separating, I turned to food for comfort I guess, and kids did start to bully me at school um poking at my body, pointing out that I was gaining weight. I did start to I guess struggle a little bit with running started to come fix at it on my body and reflecting on it now I’ve had a lot of control loss. I didn’t feel much control. I lost a lot of a lot of weight and reflecting on it now wasn’t healthy at all. But I guess I was just terrified of kids bullying me further. I needed to do something about it.

Then my mom started getting worried noticing how worried I was around food and how obsessed I was getting over what I was eating at the age 11 and um that I was losing weight and I did stop growing at the time. So that’s when she took me to the dietician to I guess help me get back on track and learn how to eat healthily.

Sam:

Alex’s experience with the dietician was such a positive one. It inspired him to figure out what healthy eating really is. Is it just about the food?

Alex:

Looking back on it, it wasn’t healthy at all the way I approached food. But I guess after that negative experience and my dietician getting me back on track if you like. I agree, to come back to it. Yes, that’s where my actual interest in healthy eating and science behind nutrition started from my dietician, I would say.

Sam:

We can’t really give you a template for healthy eating because it’s going to be different for everyone. Well, the exact makeup of a diversified, balanced and healthy diet will vary on individual characteristics, things like your cultural context, the foods that are available near you, your medical history and other things like that.

Liz:

The healthy diet is different for everyone. It depends on your culture, it depends on what is right for your budget. You can’t have freshly caught salmon every day if you live far inland. That’s not going to work for you geographically. You can’t have caviar every day if it doesn’t fit in your food budget. A healthy diet is one that fits within your budget, within your geography, within your belief system. It might be your religion or your culture. It’s a diet that takes care of your body as well as your taste buds.

So that means sometimes we might have a salad thing and then sometimes we might eat brownies because they kick ass and they’re delicious. It’s flexible. It’s a diet that doesn’t lead to restriction. It’s a diet that doesn’t lead to bingeing. It responds to your hunger and your fullness cues because we’ve got those beautiful hormones that tell us when to start and stop eating, we’ve just got to listen to them.

Sam:

So while the nutritional components of what we eat is really important. Part of a healthy diet is also about our behaviours around food. So that means we need to bring in a psychologist.

Janet:

My name is Janet Lowndes, and the founding director and principal psychologist at Mind Body Well. We’re a therapy practice in Melbourne. I’ve been a psychologist for more than 25 years and most of that time I’ve worked in the area of eating disorders and worked with people with weight and shape concerns.

So, the question of what is a healthy diet, I can’t answer that nutritionally speaking, it’s outside my scope of practice, given I’m a psychologist, not a dietitian. But I would say even most dieticians in a similar space to me would answer this similarly anyway, that it’s really important to focus more on healthy relationship with food as opposed to just what is a healthy diet. Because it’s, you know, it’s such a such a narrow question, I guess. And it’s often the very question that gets people reading advice from influencers. There are all kinds of people out there who think they know what a so-called healthy diet is. I’m putting that in air quotes because really, I’d say that a healthy relationship with food is so much more important,

Sam:

Janet says there are tools that we can use to mitigate against the multimillion-dollar marketing tactics of both the food and the diet industries and ways to nurture our physical health as well as a healthy relationship with our bodies and food.

Janet:

I often encourage people to focus on wellbeing rather than weight and to think about wellbeing also as multi factored, that we can we can think about our physical wellbeing, our psychological and social wellbeing, all kinds of different aspects of wellbeing and to think about the impact of different foods on our wellbeing is an important part of that. However, the tricky part I think is that sometimes the reason we might feel uncomfortable after eating something, sometimes that might be psychological, not physical, like it might be because of guilt. And it might be because we live in a culture that tells us that certain foods are more acceptable than others. So I do think that’s a really important part of that therapeutic conversation—to understand the response I have to certain foods: Is that my body physically feeling uncomfortable maybe because, you know, that I ate very quickly or something like that. Or is it my head saying I shouldn’t have had that, you know, again, all the air quotes, which don’t really translate on a podcast, but you know what I mean?

Sam:

We’re okay with air quotes on this podcast.

Janet:

As a therapist, I feel like it’s my role to help people unpack that relationship with certain foods. You know, what is it that comes up for me when I eat that particular food? And what’s that about? Is that about expectations? Is it about, is it about this kind of diet culture that I’ve really taken on, or is it that my body is physically saying that doesn’t feel so good.

Sam:

When it comes to health, cutting out certain food groups because you believe they’re not good for you can devolve into eating disorders like orthorexia where you so obsessed with eating the right food that it negatively affects all other areas of your life. For example, you can’t go to a restaurant or a party Because you’re worried they won’t have the right food. Orthorexia is a term that was coined in the United States in the 90s and it literally means correct diet. It could loosely be defined as an unhealthy focus on eating in a healthy way. And people who suffer from orthorexia obsess about food to the point where it can damage their overall wellbeing. So this is probably a good point to introduce our next guest.

Sophie:

I was in year 10 in high school and there was just a I guess a number of factors that led me up to initially wanting to have a more healthy lifestyle which then quite quickly spiralled into an eating disorder. My name’s Sophie and I’m currently studying to be a social worker and I’m also an eating disorders advocate with lived experience of orthorexia. We were weighed—well we had to weigh ourselves—during PE class twice a year in high school from year 7 or 10. I think that was kind of the only way I knew that my weight was kind of increasing which obviously is completely normal through puberty, but that wasn’t really emphasised to us because our culture is so obsessed with weight and being healthy and always seeing weight gain as bad. I started to get worried that I was going to put on too much weight and then become too big or unattractive. It quite quickly went from trying to be healthy to an eating disorder and honestly, probably only in a couple of months because I had those underlying personality traits, um like perfectionism and need for control.

My idea of healthy eating now is extremely different to what it was back then when I was actively in my eating disorder, but I think, you know, ideas around healthy eating are so based on restriction and deprivation, which I think is really messed up. There’s a lot of stuff around in order to be healthy involved depriving yourself and needing to have cheap foods or cheap meals. And the concept of good and bad food and having to, you know, it’s always about cutting stuff out, not adding stuff in that will be beneficial for your health. So I think, yeah, my concept of healthy eating was very like, you need to cut all the stuff out. So that did lead me to having a pretty long list of foods that I couldn’t eat or if I did eat, I feel really guilty about it because I thought it would be really bad for me. And so yeah, that was kind of how I thought about healthy eating is being, quite restrictive and it did impose a lot of restrictions on my life.

Sam:

A lot of our attitudes and beliefs about food stem from our childhood and what we saw our parents do or our family members do, or the people that we love, those attitudes that are very difficult to let go of, but they’re not always helpful.

Sam van Zweden:

I grew up in the back of the room as Weight Watchers meetings were going on and that sort of thing. And that definitely informed my view of what it meant to be a healthy eater. I’m Sam van Zweden, I’m a writer, I wrote a book called Eating with My Mouth Open and I have a history of binge eating disorder and complicated mental health and embodiment.

Sam:

Sam’s book is about food, mental health and memory, and the way all those things impact on our body. She says they’re all interconnected.

Sam van Zweden:

But as I’ve grown up, I think my relationship with food became much more complicated. I don’t remember food being particularly complicated for me growing up until my late teens. Um, I had a family doctor say to me as a result of being on some medication long term, “You’ve put on some weight, we need you to try and drop some weight over the summer”. So I really doubled down and hit Weight Watchers first really hard. And then that sort of spiralled into every diet I could get my hands on. So, at that point, I think my idea of healthy eating was about counting calories and all those rules. As that got more chaotic, I just kept punishing myself for the failure of the diets, that it wasn’t the diets, it was me doing them wrong. And we know that a natural reaction to restriction is to go hard in the other direction. Um, so that for me turned into a binge eating disorder, which has really seen me have to rethink my idea of healthy eating.

Sam:

Take me through this process of going from this dieting mind frame to the eating disorder. How did that happen?

Sam van Zweden:

I think it was a slow escalation at the time, I didn’t realize that there was anything wrong with what I was doing and because of my body type, so I’m a fat woman and because of that, the diets were working and I thought that that meant everything was good. I guess I developed some more problematic behaviours of, you know, sneaking food and hiding what I’ve been eating and really just spending all of my time thinking about my body and what was going into it and how that would affect its shape that I realized that perhaps this is not a way to live.

Liz:

I love, just behaviourally, this quote from Geneen Roth. She says that for every diet, there’s an equal and opposite binge and I think that’s so true. We try and make up for it as soon as we finish the diet.

Janet:

You know, the old fashioned, I think it’s called a Newton’s Cradle. It’s those silver balls hanging on a thread, there there’s a few of them lined up. You pull one in one direction, it bounces back and flings one off in the other direction, right? So, it’s like if we restrict ourselves physically or mentally, psychologically in any way, what’s very likely to happen is either one of two things: Either the restriction itself gains momentum and that’s where people can then sometimes develop more obsessive restrictive eating disorders. Or it flings off in the other direction. And restriction often causes this sort of feast and famine mentality physically and mentally where then we crave the very thing that we’ve been restricting.

Sam:

Okay we get it. Extremes of anything including restriction are not part of a healthy diet. We need to have a healthy relationship with food and we need to start listening to our bodies. This is what we’ve been told so far at least. But how do you do that?

Sophie:

My whole thoughts around healthy eating have changed so much. Something that really helped me in my recovery was intuitive eating and the intuitive eating um framework which was created by two dieticians, Evelyn Triboli and Elyse Resch in the U. S. And I actually read that book very early in my recovery. My parents actually got it for me for Christmas and initially it really blew my mind. It was really hard to accept that what I thought was good for me, wasn’t really. My relationship with food was so disordered and messed up at that point. So now I really try and practice intuitive eating. I don’t have any rules around food. I listen to my body as much as possible. And yeah, my notion of healthy eating has changed so much. I think it’s so much more important to have a healthy relationship with food.

Alex:

Generally speaking, just looking at old food as food and not taking a binary approach and not putting different foods in different boxes. I’ve built an understanding that all food is in limits, nothing is off limits. And then once you perceive food as being like that your body will guide you towards what it wants and what it doesn’t want.

Sam van Zweden:

If you can’t figure it out for yourself, you have full permission to outsource it, find yourself a therapist who specialises in body image and eating disorders, they can help. They can sense check you. In my recovery, part of it was to see a psychologist who specialist in those things. We did food diaries. She would go over my food diary and we’d have a chat about, you know what I’d eaten and how I felt about it and why I felt that way about it. And she was a really great external sense check for like, “The thing that you think is a problem about this list of what you’ve eaten, is it actually a problem?” And then we were able to figure out where it was a problem, where it wasn’t a problem and how we would deal with that. So rebuilding that idea of what it means to eat healthfully wasn’t something that just came out of me. It was, it was definitely outsourced. I had a lot of external help in it.

Liz:

It’s really important if you have an eating disorder, you suspect that you’ve got an eating disorder, you need to find an accredited practicing dietitian that really um has a special interest in that area because not all dieticians get trained the same and eating disorders at university. For me, it was one, one hour lecture on eating disorders and they basically said, don’t go there. So you want to find someone who has done additional training and eating disorders so they can really understand what’s going on. And someone who’s got like a little bit more of a counselling background would be good too, because part of your journey of recovery, you’ve got to have a good relationship with who you work with because you’re going have to see them a lot. So if they piss you off, that’s not going to go down well. You’re going to see them a lot, you’re going to have to trust them because that’s a massive part of the process is this trusting and building a team that works for you.

Sam:

If you think you need a dietitian or a psych who really knows their stuff when it comes to eating disorders or body image issues, Butterfly has put together a referral database and the chances are that there is somebody who meets your needs somewhere near where you are. To find out more, go to Butterfly.org.au and follow the prompts. While you’re there, jump onto Butterfly’s resources page and you’ll find some tools you can use to mitigate against the multimillion dollar marketing tactics that are put together by the food and diet industries that inundate you with so much confusing messaging about food and health. And if you need support right now remember the Butterfly Helpline. There are trained clinicians there waiting to help you from eight AM until midnight, seven days a week (AEST/AEDT). The number to call is 1 800 ED HOPE or 1 800 33 4673. I’m Sam Ikin. The show is produced by Ikin Media for Butterfly Foundation. Huge thanks to Camilla Becket and Kate Mulray from Butterfly. Our guests this week were Elizabeth’s Stathakis, Janet Lowndes, Alex Rodriguez, Sophie Smith and Sam van Zweden. Thanks for joining us again on Butterfly: Let’s Talk. If you like this podcast, please leave us a review or give us a rating. Five stars is what we prefer, but we’ll take four if you got it.